Gastrointestinal complications are associated with a poor outcome in non-critically ill pneumonia patients
Journal
BMC Gastroenterology
Journal Volume
20
Journal Issue
1
Pages
383
Date Issued
2020
Author(s)
Abstract
Background: Development of gastrointestinal (GI) complications is adversely associated with prognosis in the critically ill. However, little is known about their impact on the outcome of non-critically ill patients. In this study, we aimed to investigate the incidence of GI complications and their influence on prognosis of hospitalized pneumonia patients. Methods: Adult patients admitted with a diagnosis of pneumonia from 2012 to 2014 were included. Medical records were reviewed to obtain patients’ demographics, physical signs, comorbidities, laboratory results, clinical events, and the Confusion, Urea, Respiratory rate, Blood pressure and age ? 65 (CURB-65) score was calculated to assess the severity of pneumonia. GI complications, including bowel distension, diarrhea, GI bleeding and ileus, were evaluated during the first 3?days of hospitalization and their association with patient outcomes, such as hospital mortality and length of stay, was analyzed. Results: A total of 1001 patients were enrolled, with a mean age of 73.7?years and 598 (59%) male. Among them, 114 (11%) patients experienced at least one GI complication and diarrhea (5.2%) was the most common. The hospital mortality was 14% and was independently associated with an increase in the CURB-65 score (odds ratio [OR] 1.952 per point increase; 95% confidence interval [CI] 1.516–2.514), comorbid malignancy (OR 1.943; 95% CI 1.209–3.123), development of septic shock (OR 25.896; 95% CI 8.970–74.765), and the presence of any GI complication (OR 1.753; 95% CI 1.003–3.065). Conclusions: Compared to a critical care setting, GI complications are not commonly observed in a non-critical care setting; however, they still have a negative impact on prognosis of pneumonia patients, including higher mortality and prolonged length of hospital stay. ? 2020, The Author(s).
Other Subjects
urea; adult; age; aged; Article; blood pressure; breathing rate; clinical assessment tool; clinical feature; clinical outcome; comorbidity; confidence interval; confusion; controlled study; CURB 65 score; demography; diarrhea; disease association; disease severity; female; gastrointestinal disease; gastrointestinal hemorrhage; hospital mortality; hospital patient; hospital readmission; hospitalization; human; human cell; ileus; intestine distension; laboratory test; length of stay; major clinical study; male; malignant neoplasm; medical record review; observational study; odds ratio; pneumonia; prognosis; retrospective study; septic shock; Taiwan; critical illness; intensive care; intensive care unit; pneumonia; severity of illness index; Adult; Aged; Critical Care; Critical Illness; Hospital Mortality; Humans; Intensive Care Units; Length of Stay; Male; Pneumonia; Severity of Illness Index
Publisher
BioMed Central Ltd
Type
journal article